Healthcare Provider Details

I. General information

NPI: 1992629513
Provider Name (Legal Business Name): ALEXIS WIEN DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 E 800 S APT 103
SALT LAKE CITY UT
84102-4346
US

IV. Provider business mailing address

810 E 800 S APT 103
SALT LAKE CITY UT
84102-4346
US

V. Phone/Fax

Practice location:
  • Phone: 385-202-3901
  • Fax:
Mailing address:
  • Phone: 385-202-3901
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number128533851202
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: